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General NPI Number Information
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NPI Number | 1396491718
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Entity Type | Individual
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Provider Name | CHELSEA HAGE LICDC
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Gender | Female
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 600 DOVER CENTER RD # 3
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City | BAY VILLAGE
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State | OH
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Zip | 44140-3310
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Country | US
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Telephone | 440-742-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 1972 E 29TH ST
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City | LORAIN
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State | OH
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Zip | 44055-1911
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Country | US
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Telephone | 440-714-2860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.162860
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License Number State | OH
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